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Deactivated NPI 1053472571 Deactivated / Inactive NPI Male Practitioner

Dr. William C. Self Dds,ps , WILLIAM SELF DDS

Dentist - General Practice • Seattle, WA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. William Self Dds,ps has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 12, 2006
NPI Deactivation Date December 25, 2025
Total Practice Duration ~19 Years of Practice (2006 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. William Self Dds,Ps, WILLIAM SELF DDS was a registered Dentist - General Practice practicing in Seattle, WA. Throughout an active medical career spanning 19 years, Dr. Self Dds,Ps provided care at the practice location at 11227 ROOSEVELT WAY NE until profile deactivation on 2025-12-25.

Practice Location & Contact Primary Location

Practice Address

11227 Roosevelt Way Ne

Seattle, WA 981259812

Telephone 2063626838
Fax 2063621299
Associated Practice Facility / Clinic
🏢 Reen Chung Dds Pllc Facility NPI 1881047470

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Seattle, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 20.3 Yrs
State Avg: 21.3 Yrs
Regional Practice Density
459 Specialists

Practicing in Seattle, WA (3345 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License WA 4303

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1932391877

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated December 25, 2025

Record deactivated on December 25, 2025

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 11227 ROOSEVELT WAY NE, SEATTLE, WA 981259812 (Tel: 2063626838)

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Updated Business Mailing Address July 08, 2007

Registered at 11227 ROOSEVELT WAY NE, SEATTLE, WA 981259812 (Tel: 2063626838)

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Provider Name / Credentials Updated July 08, 2007

Recorded as WILLIAM SELF DDS,PS, WILLIAM SELF DDS,

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #4303 in WA)

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Initial NPI Registration & Enumeration December 12, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1053472571
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 12, 2006
Last Update: July 08, 2007
Deactivation Date: December 25, 2025

Mailing Address

11227 Roosevelt Way Ne

Seattle, WA 981259812

Phone: 2063626838

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.